Remote prescribing with Geva Greenfield and Benedict Hayhoe

Deep Breath In

The past year has seen an increase in antibiotic prescriptions, especially for broad-spectrum antibiotics. This might be due to the rise in teleconsultations, which limit the ability to examine patients, causing GPs to experience higher levels of uncertainty in making diagnoses. This week, we discuss the impact that COVID-19, and COVID tests, have had on access to healthcare, the risk of antimicrobial resistance, and how the pandemic has altered the presentation and case mix seen in GP surgeries. With teleconsulting likely here to stay, how do we adjust to the changes in primary care provision, in order to prescribe with confidence? And how do we become good antibiotic stewards? Our guests: Geva Greenfield is a research fellow in the Department of Primary Care & Public Health at Imperial College London’s School of Public Health. His research focuses on primary care and health policy, and big healthcare data analytics. Benedict Hayhoe is a London-based GP, and a clinical lecturer in the Department of Primary Care & Public Health at Imperial College London’s School of Public Health. His research interests include digital health and antimicrobial resistance. Further reading: https://www.expmedndm.ox.ac.uk/step-up Armitage A, Nellums L. Antibiotic prescribing in general practice during COVID-19. The Lancet Infectious Diseases 2020. https://doi.org/10.1016/S1473-3099(20)30917-8 de Lusignan S, Joy M, Sherlock J, Tripathy M, van Hecke O, Gbinigie O et al. PRINCIPLE trial demonstrates scope for in-pandemic improvement in primary care antibiotic stewardship. medRxiv. 2021. https://doi.org/10.1101/2021.02.02.21250902 Han SM, Greenfield G, Majeed A, Hayhoe B. Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review. Journal of Medical Internet Research 2020; 22(11):e23482. https://doi.org/10.2196/23482 Hayhoe B, Butler C, Majeed A, Saxena S. Telling the truth about antibiotics: benefits, harms and moral duty in prescribing for children in primary care. Journal of Antimicrobial Chemotherapy 2018; 73(9):2298-2304. https://doi.org/10.1093/jac/dky223 Hayhoe B, Greenfield G, Majeed A. Is it getting easier to obtain antibiotics in the UK? British Journal of General Practice 2019; 69(679):54-55. https://doi.org/10.3399/bjgp19X700829 Morrell L, Buchanan J, Roope L, Pouwels K, Butler C, Hayhoe B et al.. Delayed Antibiotic Prescription by General Practitioners in the UK: A Stated-Choice Study. Antibiotics 2020; 9(608). https://doi.org/10.3390/antibiotics9090608 Shah S, Wordley, Thompson W.. How did COVID-19 impact on antibiotic prescribing across England? British Dental Journal 2020; 229(9):601-604. https://doi.org/10.1038/s41415-020-2336-6 van de Pol A, Boeijen J, Venekamp R, Platteel T, Damoiseaux R, Kortekaas M et al.. Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study. Antibiotics 2021; 10(196). https://doi.org/10.3390/antibiotics10020196 Zhu N, Aylin P, Rawson T, Gilchrist M, Majeed A, Holmes A.. Investigating the impact of COVID-19 on primary care antibiotic prescribing in North West London across two epidemic waves. Clinical Microbiology and Infection 2021. https://doi.org/10.1016/j.cmi.2021.02.007